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Article: Handgrip Strength and Anthropometry in Parkinson's Disease at Diagnosis.

Håglin, Lena / Törnkvist, Birgitta / Edström, Mona / Håglin, Sofia / Bäckman, Lennart

2022 Volume 2022, Page(s) 1516807

Abstract: Objectives: To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to ... ...

Abstract	Objectives: To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to controls. Results: Low fat-free mass index (FFMI), MNA score, and a high Unified Parkinson's Disease Rating Scale (UPDRS-total and UPDRS-III) were associated with high daytime levels of P-cortisol in total PD population but not in controls. Partial correlations reveal that high fat mass percent (FM (%)) and low FFMI were associated with older age in males with PD but not females with PD. Risk of malnutrition was associated with P-cortisol in males but not in females with PD ( Conclusions: Age- and disease-associated risk factors that decrease muscle mass and HGS and increase FM (%) in patients with PD differ between males and females by an association with levels of cortisol and phosphate.
Language	English
Publishing date	2022-07-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573854-9
ISSN	2042-0080 ; 2090-8083
ISSN (online)	2042-0080
ISSN	2090-8083
DOI	10.1155/2022/1516807
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Article ; Online: Obesity, smoking habits, and serum phosphate levels predicts mortality after life-style intervention.

Håglin, Lena / Törnkvist, Birgitta / Bäckman, Lennart

PloS one

2020 Volume 15, Issue 1, Page(s) e0227692

Abstract: Background: Life-style interventions, including smoking cessation and weight control are of importance for managing future escalating prevalence of obesity. Smoking habits and obesity have jointly great impact on mortality, however mechanisms behind the ...

Abstract	Background: Life-style interventions, including smoking cessation and weight control are of importance for managing future escalating prevalence of obesity. Smoking habits and obesity have jointly great impact on mortality, however mechanisms behind the effect and variables involved in the obesity paradox is still unknown. Objectives: This study examines risk factors for all-cause, cardiovascular, and cancer mortality in males and females with high cardiovascular risk, mediated by smoking habits, body mass index (BMI, kg/m2), and serum phosphate (S-P) levels. Methods: Patients were admitted to the Vindeln Patient Education Center in groups of 30 for a four-week residential comprehensive program (114 hours) focusing on smoking cessation, stress reduction, food preferences and selections, and physical exercise. The follow-up, in years from 1984 to 2014 corresponds to 30 years. This study included 2,504 patients (1,408 females and 1,096 males). Cox regression analysis was used to assess mortality risk associated with smoking habits, low and high BMI, and low and high S-P levels. Results: High BMI (>34,2 kg/m2), current smoking, type 2 diabetes mellitus (T2DM), high serum calcium (S-Ca), mmol/L and high systolic blood pressure (SBP, mmHg) were associated with all-cause mortality irrespective of sex. Former and current smoking females had a high all-cause mortality (adjusted hazard ratio [HR] 1.581; 95% CI 1.108-2.256, adjusted hazard ratio [HR] 1.935; 95% CI 1.461-2.562, respectively) while current smoking and high BMI increased risk for cardiovascular mortality (adjusted hazard ratio [HR] 3.505; 95% CI 2.140-5.740 and [HR] 1.536; 95% CI 1.058-2.231, respectively). Neither low nor high levels of S-P predicted all-cause, cardiovascular disease (CVD) and cancer mortality in males or females while low levels of S-P predicted all-cause mortality in smokers (adjusted hazard ratio [HR] 1.713; 95% CI 1.211-2.424). In non-smokers, low BMI (<27.6 kg/m2) was protecting and high BMI a risk for all-cause mortality. In males, ischemic heart disease (IHD), and low serum albumin (S-Alb) were associated with all-cause mortality. In females, an interaction between high BMI and smoking (HbmiSM) decreased the cardiovascular mortality (adjusted hazard ratio [HR] 0.410; 95% CI 0.179-0.937, respectively). Conclusions: High BMI and current smoking were associated with all-cause mortality in both males and females in the present high cardiovascular-risk cohort. In current smokers and non-smokers, T2DM and high S-Ca were associated with an increase in all-cause mortality, while low S-P was associated with all-cause mortality in smokers. Interaction between high BMI and smoking contribute to the obesity paradox by being protective for cardiovascular mortality in females.
MeSH term(s)	Adult ; Body Mass Index ; Cohort Studies ; Female ; Health Promotion/methods ; Healthy Lifestyle ; Humans ; Male ; Middle Aged ; Obesity/blood ; Obesity/mortality ; Obesity/therapy ; Phosphates/blood ; Risk Factors ; Smoking/blood ; Smoking/mortality ; Smoking/therapy ; Smoking Cessation ; Sweden/epidemiology ; Weight Reduction Programs
Chemical Substances	Phosphates
Language	English
Publishing date	2020-01-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0227692
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Article ; Online: Covariation between plasma phosphate and daytime cortisol in early Parkinson's disease.

Håglin, Lena / Bäckman, Lennart

Brain and behavior

2016 Volume 6, Issue 12, Page(s) e00556

Abstract: Background: Disturbed phosphate homeostasis in early Parkinson's disease (PD) may originate from a stress-related condition and nutritional status among other risk factors, age, and gender.: Methods: Risk of malnutrition using Mini-nutritional ... ...

Abstract	Background: Disturbed phosphate homeostasis in early Parkinson's disease (PD) may originate from a stress-related condition and nutritional status among other risk factors, age, and gender. Methods: Risk of malnutrition using Mini-nutritional assessment (MNA score) and plasma levels of protein markers and daytime cortisol at the time of diagnosis in PD ( Results: The patients with PD had significantly lower MNA score than controls which correlated with plasma phosphate levels. The logistic regression revealed that increasing MNA protected from low plasma phosphate, final score (OR = 0.399; 95% CI = 0.196-0.816; Conclusion: This study highlights the importance of phosphate for optimal nutritional status by association with MNA score and albumin in plasma. An inverse relationship between phosphate and cortisol indicate, in addition, that low phosphate levels may affect cognition and motor function in PD.
MeSH term(s)	Aged ; Aged, 80 and over ; Antiparkinson Agents/therapeutic use ; Case-Control Studies ; Circadian Rhythm ; Cognition/physiology ; Female ; Humans ; Hydrocortisone/blood ; Levodopa/therapeutic use ; Logistic Models ; Male ; Malnutrition/blood ; Middle Aged ; Nutrition Assessment ; Parkinson Disease/blood ; Parkinson Disease/drug therapy ; Parkinson Disease/psychology ; Phosphates/blood ; Serum Albumin/metabolism ; Transferrin/metabolism
Chemical Substances	Antiparkinson Agents ; Phosphates ; Serum Albumin ; Transferrin ; Levodopa (46627O600J) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2016-10-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2623587-0
ISSN	2162-3279 ; 2162-3279
ISSN (online)	2162-3279
ISSN	2162-3279
DOI	10.1002/brb3.556
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Article: High serum phosphate and triglyceride levels in smoking women and men with CVD risk and type 2 diabetes.

Håglin, Lena M / Törnkvist, Birgitta / Bäckman, Lennart O

Diabetology & metabolic syndrome

2014 Volume 6, Issue 1, Page(s) 39

Abstract: Background: Both low and high serum phosphate levels may be associated with morbidity and mortality from cardiovascular disease. As smoking increases risk for type 2 diabetes (as shown by dyslipidemia and hyperglycemia), we wanted to study whether ... ...

Abstract	Background: Both low and high serum phosphate levels may be associated with morbidity and mortality from cardiovascular disease. As smoking increases risk for type 2 diabetes (as shown by dyslipidemia and hyperglycemia), we wanted to study whether smoking and type 2 diabetes were associated with serum phosphate and triglyceride levels independently from other CVD risk factors. Methods: Upon admittance to the Vindeln Health Education Centre (VHE-centre) for a four-week comprehensive lifestyle intervention, the participants (1408 women and 1096 men) completed a questionnaire that included their smoking habits - current smoker or non-smoker. We used multiple linear regression analyses to investigate the association between smoking and other CVD risk factors with S-P and S-TG levels. Results: In the non-type 2 diabetes populations, the smokers, compared to the non-smokers, had higher S-P and higher serum triglycerides (S-TG). In women, serum-TG in smokers with type 2 diabetes was higher than in smokers with non-type 2 diabetes. Non-type 2 diabetes patients exhibited an inverse relation between S-Glucose (S-Glu) and S-P and a positive association with S-TG. For men only, an association was seen between age (-) and S-Crea (-) and S-P. For women only, an association was seen between BMI (-) and S-Cholesterol (+) (S-Chol) and S-P. Conclusions: Compared to non-smokers, smoking women with non-type 2 diabetes and smoking men with type 2 diabetes had a higher level of S-P and S-TG. The association between smoking and S-P and S-TG levels still existed after adjusting for age and CVD risk factors in the multiple linear regression analyses. Trial registration: The study has been registered as a sub-study to the Lifestyle Intervention Trial no. ISRCTN79355192.
Language	English
Publishing date	2014-03-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2518786-7
ISSN	1758-5996
ISSN	1758-5996
DOI	10.1186/1758-5996-6-39
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Article ; Online: A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum Calcium, -magnesium and -phosphate in Type 2 diabetes and non-diabetes metabolism

Håglin Lena / Bäckman Lennart / Törnkvist Birgitta

Cardiovascular Diabetology, Vol 10, Iss 1, p

2011 Volume 116

Abstract: Abstract Background This study investigates the associations between changes in serum Triglycerides (S-TG), -Urate (S-Urate), and -Glucose (S-Glu) and changes in serum Calcium (S-Ca), -Magnesium (S-Mg), and -Phosphate (S-P) in patients with type 2 ... ...

Abstract	Abstract Background This study investigates the associations between changes in serum Triglycerides (S-TG), -Urate (S-Urate), and -Glucose (S-Glu) and changes in serum Calcium (S-Ca), -Magnesium (S-Mg), and -Phosphate (S-P) in patients with type 2 diabetes compared with non-diabetic patients. Methods The analysis is based on data collected from a secondary prevention population of women and men (W/M) at risk for cardiovascular disease (type 2 diabetes, 212/200; non-diabetes 968/703). The whole population (n = 2083) had a mean age of 51.0 (9.7) years and was stratified for sex and according to type 2 diabetes or non-diabetes. The patients were followed for, either half a year or one year and changes in risk factors were calculated from follow-up to baseline, the time when patients were admitted to the health center. The pattern of relationships was evaluated using a structural equation model. Results Higher S-TG and S-Glu but lower S-Urate was revealed at baseline in type 2 diabetes women and men as compared to their counterparts, non-diabetes patients. Women with type 2 diabetes had higher S-Ca and lower S-Mg than non-diabetes women. Changes in S-Glu were associated with changes in S-Ca (+), baseline S-Ca (+), and S-Urate (-) in type 2 diabetes men. Changes in S-Urate were associated with changes in S-Mg (+) in type 2 diabetes women and non-diabetes men. In men with non-diabetes, changes in S-Glu were associated with changes in S-Mg (-). In women with non-diabetes, changes in S-Glu were associated with changes in S-P (-) and changes in S-Urate with changes in S-Ca (+). Conclusion With respect to metabolic disturbances in non-diabetes and the awareness of risk for type 2 diabetes, changes in S-Glu and changes in S-Ca, S-Mg, and S-P should be considered as risk factors for cardiovascular disease. Increased early detection and corrections of high S-Ca, low S-Mg, and S-P in obese patients may improve their metabolism and reduce the risk of CVD in patients with type 2 diabetes. Trial registration number ISRCTN: ISRCTN79355192
Keywords	Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	571
Language	English
Publishing date	2011-12-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum calcium, -magnesium and -phosphate in type 2 diabetes and non-diabetes metabolism.

Håglin, Lena / Bäckman, Lennart / Törnkvist, Birgitta

Cardiovascular diabetology

2011 Volume 10, Page(s) 116

Abstract: Background: This study investigates the associations between changes in serum triglycerides (S-TG), -urate (S-Urate), and -glucose (S-Glu) and changes in serum calcium (S-Ca), -magnesium (S-Mg), and -phosphate (S-P) in patients with type 2 diabetes ... ...

Abstract	Background: This study investigates the associations between changes in serum triglycerides (S-TG), -urate (S-Urate), and -glucose (S-Glu) and changes in serum calcium (S-Ca), -magnesium (S-Mg), and -phosphate (S-P) in patients with type 2 diabetes compared with non-diabetic patients. Methods: The analysis is based on data collected from a secondary prevention population of women and men (W/M) at risk for cardiovascular disease (type 2 diabetes, 212/200; non-diabetes 968/703). The whole population (n = 2083) had a mean age of 51.0 (9.7) years and was stratified for sex and according to type 2 diabetes or non-diabetes. The patients were followed for, either half a year or one year and changes in risk factors were calculated from follow-up to baseline, the time when patients were admitted to the health center. The pattern of relationships was evaluated using a structural equation model. Results: Higher S-TG and S-Glu but lower S-Urate was revealed at baseline in type 2 diabetes women and men as compared to their counterparts, non-diabetes patients. Women with type 2 diabetes had higher S-Ca and lower S-Mg than non-diabetes women. Changes in S-Glu were associated with changes in S-Ca (+), baseline S-Ca (+), and S-Urate (-) in type 2 diabetes men. Changes in S-Urate were associated with changes in S-Mg (+) in type 2 diabetes women and non-diabetes men. In men with non-diabetes, changes in S-Glu were associated with changes in S-Mg (-). In women with non-diabetes, changes in S-Glu were associated with changes in S-P (-) and changes in S-Urate with changes in S-Ca (+). Conclusion: With respect to metabolic disturbances in non-diabetes and the awareness of risk for type 2 diabetes, changes in S-Glu and changes in S-Ca, S-Mg, and S-P should be considered as risk factors for cardiovascular disease. Increased early detection and corrections of high S-Ca, low S-Mg, and S-P in obese patients may improve their metabolism and reduce the risk of CVD in patients with type 2 diabetes. Trial registration number: ISRCTN: ISRCTN79355192.
MeSH term(s)	Adult ; Biomarkers/blood ; Blood Glucose/metabolism ; Calcium/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Case-Control Studies ; Chi-Square Distribution ; Diabetes Complications/blood ; Diabetes Complications/etiology ; Diabetes Complications/prevention & control ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/therapy ; Female ; Humans ; Least-Squares Analysis ; Magnesium/blood ; Male ; Middle Aged ; Models, Biological ; Phosphates/blood ; Regression Analysis ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Sweden ; Time Factors ; Treatment Outcome ; Triglycerides/blood ; Uric Acid/blood
Chemical Substances	Biomarkers ; Blood Glucose ; Phosphates ; Triglycerides ; Uric Acid (268B43MJ25) ; Magnesium (I38ZP9992A) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2011-12-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1475-2840
ISSN (online)	1475-2840
DOI	10.1186/1475-2840-10-116
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Article: Inherited corneal opacifications with an unusual distribution.

Fagerholm, Per / Dellby, Anette / Bäckman, Lennart

Acta ophthalmologica Scandinavica

2007 Volume 85, Issue 1, Page(s) 103–105

Abstract: Purpose: To describe corneal opacities of a new type and distribution in a small family.: Methods: Family members were interviewed and examined to establish a pedigree and to detect any corneal abnormalities.: Results: Two family members presented ...

Abstract	Purpose: To describe corneal opacities of a new type and distribution in a small family. Methods: Family members were interviewed and examined to establish a pedigree and to detect any corneal abnormalities. Results: Two family members presented with corneal opacities. Both had, in the very peripheral cornea, flat, greyish, rounded opacities, 20-200 microm in diameter, on the Descemet's membrane. In addition, the mother had the same type of opacities over the central cornea just inside the Bowman's layer. The remaining parts of the corneas were clear. Vision was unaffected and the opacities caused no discomfort. There was no other corneal pathology. The subjects' general health was good. Conclusions: To our knowledge, these types and distribution of corneal opacities have not been described previously. Although the mode of inheritance at this point is uncertain, we believe the changes are of a dystrophic nature.
MeSH term(s)	Adult ; Corneal Opacity/diagnosis ; Corneal Opacity/genetics ; Descemet Membrane/pathology ; Female ; Humans ; Male ; Middle Aged ; Pedigree
Language	English
Publishing date	2007-02
Publishing country	Denmark
Document type	Case Reports ; Journal Article
ZDB-ID	1230907-2
ISSN	1600-0420 ; 1395-3907
ISSN (online)	1600-0420
ISSN	1395-3907
DOI	10.1111/j.1600-0420.2006.00756.x
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Article ; Online: All-cause mortality of patients with dyslipidemia up to 19 years after a multidisciplinary lifestyle modification programme: a randomized trial.

Håglin, Lena / Lundström, Sara / Kaati, Gunnar / Bäckman, Lennart / Bygren, Lars Olov

European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology

2011 Volume 18, Issue 1, Page(s) 79–85

Abstract: Background: Many studies have shown that individual lifestyle factors are associated with cardiovascular mortality and all-cause mortality. Observational studies of comprehensive programmes have reported risk reductions. The objectives were to assess ... ...

Abstract	Background: Many studies have shown that individual lifestyle factors are associated with cardiovascular mortality and all-cause mortality. Observational studies of comprehensive programmes have reported risk reductions. The objectives were to assess the long-term all-cause mortality by diagnosis in patients referred to a lifestyle modification programme, aimed at combating coronary heart disease and stroke. Methods: A randomized trial with 325 patients referred to the centre between 1988 and 1989 for dyslipidemia, hypertension, type 2 diabetes and coronary heart disease; 239 patients were randomized to the programme, 86 randomized to usual care. Cases were admitted to the centre in groups of 30 for a 4-week residential comprehensive activity, in total 114 full-time hours, focusing on food preferences and selections, and physical exercise. The activities were repeated during a 4-day revisit to the centre 1 year and 5 years after the 4-week intervention. Controls were referred back to their doctors, mainly in primary care, for usual care. Main outcome measure was all-cause mortality during 11–12 and 18–19 years after intervention. Results: At follow-up 11–12 years after referral, the relative risk reduction (RRR) was 76% with the intention-to-treat analysis among cases admitted for dyslipidemia (hazards ratio 0.24, confidence interval 0.06–0.89, P = 0.033). After 18–19 years, the RRR was 66% (hazards ratio 0.34, confidence interval 0.13–0.88, P = 0.026). No RRR was found for the other three diagnoses. Conclusion: Patients admitted for dyslipidemia reached a real long-term RRR of all-cause mortality. They had by definition a need for this programme.
MeSH term(s)	Aged ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Cause of Death ; Chi-Square Distribution ; Diet/adverse effects ; Dyslipidemias/complications ; Dyslipidemias/mortality ; Dyslipidemias/therapy ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Preventive Health Services ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Sweden/epidemiology ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2011-02
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2124191-0
ISSN	1741-8275 ; 1741-8267
ISSN (online)	1741-8275
ISSN	1741-8267
DOI	10.1097/HJR.0b013e32833a65cc
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Article: Handgrip Strength and Anthropometry in Parkinson's Disease at Diagnosis.

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Article ; Online: Obesity, smoking habits, and serum phosphate levels predicts mortality after life-style intervention.

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Article ; Online: Covariation between plasma phosphate and daytime cortisol in early Parkinson's disease.

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Article: High serum phosphate and triglyceride levels in smoking women and men with CVD risk and type 2 diabetes.

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Article ; Online: A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum Calcium, -magnesium and -phosphate in Type 2 diabetes and non-diabetes metabolism

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Article ; Online: A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum calcium, -magnesium and -phosphate in type 2 diabetes and non-diabetes metabolism.

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Article: Inherited corneal opacifications with an unusual distribution.

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Article ; Online: All-cause mortality of patients with dyslipidemia up to 19 years after a multidisciplinary lifestyle modification programme: a randomized trial.

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